One patient developed intracranial infection caused by extensively drug-resistant(XDR) Acinetobacter baumannii after intranasal endoscopic optic nerve decompression, intravenous combined intrathecal injection of tigecycline was given, treatment plan was finally determined through comprehensive analysis on relevant literatures in the past five years. Patient received intravenous drip of tigecycline (100 mg initially, followed by 50 mg, q12h) combined with cefoperazone sodium/sulbactam sodium (3.0 g, q8h); intrathecal injection of tigecycline 2.5 mg combined with 5 mL saline, q12h through lumbar cisterna drainage tube, clipping for 2 hours. After intrathecal injection of tigecycline for 15 days, four consecutive routine cerebrospinal fluid examination of patients were all within the normal limits, the culture result was negative, patient was finally cured.